Thursday, January 29, 2009

The pan-positive patient

Otherwise known as the "triple P", the pan-positive patient will report that EVERYTHING is wrong with them if you ask. If they've never heard of something before (such as uterine fibroids) they will ask what that is, just to make sure that they haven't been told in the past that they have such a malady, or maybe they just want to go home and google it so they can check themselves for occult symptoms. The PPP ranges from sad to comical to simply annoying. Sad if they really do have so many illnesses that not a single organ system is healthy. Here's an example:
Me: Good Morning Mrs. Peabody, I need to ask you a few questions and review your medical history. I understand from your chart that you have CHF? and you've had a minor stroke? But you're not sure when... um. okay. So you also have hypothyroidism, diabetes, fibromyalgia, manic depression, rheumatoid arthritis, and dandruff? And you're deaf in one ear and you can't taste things that are sour? And you're a morbidly obese cocaine addict with a 3 pack a day cigarette habit for the last 40 years? Anything else?
Mrs. Peabody: I have a lump up under my left armpit halfway down to my hip. and sometimes the pads of three of the fingers on my left hand feel a little fuzzy. And sometimes I get this cramping feeling that moves from my back around to the front.
Me: Ohhhkay... so to review, you're also worried about some tingling in your hand and a back lump and abdominal cramping?
Mrs. Peabody: Yeah... I'm going in for A full body CT scan tomorrow.
Me: Umm... sounds great. I think I have that down. Any surgeries?
Mrs. Peabody: I had to have surgery after I jumped out of a 3-story window and my arm fell apart. And also a dog bit my leg to the bone and I had to get that opened up. And I had my tonsils out when I was 12.
Me: erm... okayy... so why did you come in today?
Mrs. Peabody: well, I'm having some discharge from down there, and I haven't been to the lady-doctor for about 15 years so I figured I should come get checked up on.


Note: this patient is fictional but her story isn't much of a stretch. I combined a few patients to make her but you see some crazy stuff at a county hospital. People come into the ER with a duffel bag full of meds and a complaint of "feeling lousy". Well, ma'am, you haven't gotten out of your bed except to use your bedside commode for 6 months, you drink a pitcher of margaritas several times a week, you weigh 450 lbs, and you smoke like a chimney. You can't do that to your body and expect to feel good. It's like filling a car's engine with horse manure instead of gasoline and being shocked that it won't run. ugh.

Monday, January 26, 2009

Do you Fondue?

If you have a random fondue pot sitting around gathering dust, you should stop that and use it. We did with marvelous results.
Recipe for Chocolate Fondue (as made by E, because he's awesome):
2 Cups Milk Chocolate chips (we used ghiradelli)
3 Tbsp Heavy Cream
2 Tbsp liqueur (or red wine if you have none)
Dash of Cinnamon

Heat up the chocolate chips on moderate heat in the microwave, stirring them to melt them. Then add the heavy cream, stirring the entire time. Then add the liqueur and stir again, then add cinnamon. Then dip anything and everything you can find into the fondue. We used strawberries, Mandarin Oranges, apple slices, and marshmallows. It makes way more than enough for two people.

For the record, My favorite dipping item was the orange slices, but E liked the marshmallows. I found them a bit too rich.
The fondue is enough food to make a meal if you don't get hung up on the whole finish your vegetables before you get any dessert thing.
in other news, my job/school situation is a joke. and if you don't like med students then definitely go to a private hospital because we're not allowed to touch ANYTHING. the residents hardly are.

Sunday, January 25, 2009

16 facts

My sister inspired this post... I've not been too inspired lately. So here goes... 16 random facts about myself

1. I was born in Mission Viejo, CA. I moved cities at the ages of 3, 6, 9, 11, 12, 18, and 22. Plus house moves within the cities.

2. My favorite book is War and Peace. I've read it twice. My old favorite was Pride and Prejudice. I also like Forster.

3. But when I want something light and easy I go for Agatha Christie novels. I've been reading them since I was 12 and I'm starting to have a hard time finding books I haven't read of hers.

4. I have two sisters who look more like each other than I look like them. but we still all look pretty darn similar. but I'm the tallest :)

5. I like things that are tweed/patterned/textured/paisley/multicolored. My winter coat isn't black, it's red and white tweed. and I only have two pairs of black socks... the others are all different colors and patterns.

6. During my sophomore year of college, my weight got up to over 200 lbs. I managed to gain the freshman 20 while working out around 20+ hours a week. I'm grossed out when I think about the amount of food that I must have been consuming in order to do that. And I thank my lucky stars that I got mono and dropped 20 lbs.

7. In college I double majored in Biological Anthropology & Anatomy and Cultural Anthropology. That's right... two kinds of anthropology. which is why I'm now in even more school. I also minored in Religion.

8. I believe in luck and I think that I am a lucky person. Ridiculously lucky. I also think that fortune cookies can shape your life if you only believe in them (the week before I met E I got one that said "the one you love is closer than you think")

9. People from my past (like, elementary school) sometimes recognize me. It's because I look incredibly similar to my childhood self.

10. My favorite food is a good peanut butter and jelly sandwich made with crunch peanut butter, raspberry fruit preserves, and toasted wheat bread.

11. I like dancing to 80's music. If it comes on in a bar I can't really help myself. Even if it's not a dancing type bar.

12. I have a tiara that I bought for myself. I sometimes put it on if I'm having a bad day when I sit around the house. Also, I sometimes wear it to sing karaoke in dive bars.

13. I used to be more of a wine person, but I've been transitioning to trying lots of different kinds of good beers. but I'm having my wedding reception at a winery so maybe I'll transition back.

14. I've always thought that I would end up in Austin once I'm done with my training (7 years down, 5-6 more to go!)

15. I love Sunday mornings and making big breakfasts before going to church. This morning was a spinach and white cheddar omelet, toast with honey and butter, turkey bacon, coffee, and grapefruit juice.

16. I have a dog now. I got him when I got E. He used to be E's dog but now he's mine too... His name is Reagan and he's a Basenji mix. He can fly and he receives free internet in his head. He also invented the internet.

Wednesday, January 21, 2009

Five years

It's been five years since my dad died, and it's still hard. I'm getting more used to not having him, but I still get upset that he was taken so soon. And it kills me that my father never got to meet E. And that on my wedding day I'll be walking myself down the aisle. And a million other little day to day things where I'm reminded that he's not here and I wish he were. I miss him.

Tuesday, January 20, 2009

Just because

I can act cheerful when told to be ready to present my patients tomorrow at 5:40. Does that make me a good med student or a good actress? I'm not sure. Last night I had three margaritas at dinner and still made it to work by 5:15. That's definitely the sign of a good med student.
Today we had a meeting in a room with a big honey-baked ham. And I hadn't eaten lunch and I was starving after a c-section. You know how sometimes in cartoons when someone was hungry then they could look at a chair and it would in their mind turn into a pork chop? well that would probably have already happened because I was that hungry. Except instead of hallucinating, I was listening to a lecture with a big-ass delicious-smelling honey-baked spiral-cut ham in front of my nose. So I did what any reasonable person would...I started snatching pieces of meat off of the ham with my fingers and eating them while the lecturer wasn't looking at me. And it was fantastically satisfying. What's up with my extended blogs about roasted meats recently? Can't tell you. but they sure are tasty.

Sunday, January 18, 2009

another weird dream

Last night I had a dream that I was giving birth, and it was really easy. I remember being shocked that there was so little pain... in my dream, I remember asking if I'd gotten an epidural or something and when I was told no, I hadn't, I started wondering to myself what all the fuss was about with everyone else. In reality it was probably non-painful because A) I have never actually experienced childbirth and B) I don't know if one can feel pain in dreams. come to think of it I'm not sure I ever have. I was also shocked in my dream because I've always assumed that I'll have to have cesareans like my mom and sister did.
And for the record, no worries because I am NOT pregnant. I am extremely certain of this. The dream was spurred by my spending so much time around ladies pushing out babies all day. Felicidades Mama!
Today was amazing and relaxing... E got home last night and we slept in. Then we got up, took our dog Reagan for a walk and then to the white rock dog park (we let him go swimming today!) and went up to Plano to have brunch with his parents. Then E did some work on my car because he's all manly and he can do man stuff. I helped a little. We took Reg back to the expensive dog house (E's old apartment... mine doesn't allow pets sadly), went to Central Market, and made dinner together. It sounds a little boring in writing but it was somehow just a perfectly perfect and relaxed day. I kind of wish all my days could be so boring. Back to work tomorrow. It's gonna be a whole different kind of boring.

Thursday, January 15, 2009

Holy Smokes!!!!

Central Market has smoked turkey legs next to their rotisserie chickens. how did I not know about this prior to today? it's one of my favorite foods but I think partly because you can only buy it at random places like fairs and sometimes football games. I never imagined that I would be able to sit in the comfort of my own home and devour this delectable delight (maybe I did it in front of my computer... and maybe my keyboard is a little greasy now... so sue me. E's out of town visiting his sick grandpa and I've been pretty blue. I'm probably going to finish a pint of ice cream later. want to judge me on that too? I'm also drinking a beer by myself. Out of the bottle. it's fantastic. These are some of the little things that help me through my day.)

petty complaint?

people have a habit of treating medical students like poo. the best we usually can do is stay under the radar, do a pretty decent job, and try not to piss anyone off. Our time is not important. example: today I was supposed to be finished by 12:30. For some of my colleagues, it was their day off. but the attending decided at 11:00 that we're all going to meet at 3 pm for unknown reasons (probably having to do with him passing on wondrous knowledge). One of the guys I work with lives in PLANO. He thought he was finished around 8 am, and probably went home. but he will now have to drive BACK to Dallas and then back again to Plano because there was no advance knowledge of this meeting. which sucks. Our resident told us that there were certain days where she doesn't want to see us sitting down... which would be fine, if there were actually enough work to keep four medical students and one PA student busy for 10 hours straight. but there just isn't. So we're supposed to walk around looking serious and industrious and like we're doing work when there IS no work that we can actually do. It's a farce. And it's silly. Why can't we have some reason here? why can't we know about things more than a few hours in advance? or better yet, have the meeting tomorrow when we're all going to likely be sitting for several hours because apparently it's slow season for babies to be born? It just don't make no sense. And don't get me wrong... I work hard. I get stuff done. When there's actual work to do I'm Miss Brass Tacks. but I HATE it when I'm forced into inactivity disguised as busyness inside of a hospital. And I hate it when my day is chopped up into bits. And I need a nap. boo.

Tuesday, January 13, 2009

totally weird dream

the other night I had a dream that wolves were following me around, and I was afraid that they might bite me. but the wolves were also pants. as soon as I hung up the wolf-pants, they were just furry trousers. likewise if I put the wolf-pants on. But if I let them loose, they became little wolfies that followed me around. What on earth does this mean?
L&D update: people think that labor and childbirth are magical... maybe so if it's actually your baby. But from my perspective it's smelly and takes a long time and everyone gets tired. And there's blood and poop and different kinds of fluids and sometimes the anesthesia doesn't work if you aren't lucky. Not so much magic as hard work. There's a reason why it's called "labor".

B, please don't get scared by this. yours will probably be the magical exception. And it also won't be at Jurassic Parkland.

Thursday, January 8, 2009

didn't take long

didn't take long for my resolutions to go down the toilet. Here's a list of what I did today:
5:00 wake up, after around five hours of sleep. I'm late heading out the door and have no more Clif bars so I grab a Reeses cup and a fun sized Kit Kat for breakfast.
7:00 AM start work
11:00 AM start coaching a lady to push out her baby
12:00 PM go to lunch at the cafeteria because I obvi didn't make anything ahead of time. Spend $6.50 on a veggie sandwich and chips. It was delicious.
12:55 back in room with pushing lady. Yank a baby out of her Uterus (gently).
1:30 to OR with new mom and her grade 4 perineal tear to sew it up. Felicidades Mama! (I'm totally getting my babies cut out!)
5:00 Off work
5:30 get home, eat a piece of chocolate cake, drink a beer, take a nap in my scrubs. Likelihood of workout= low.
I think I killed every single resolution I made for this year. Huzzah!

Monday, January 5, 2009

Resolutions 2009

Last year's resolutions, and their outcomes:

treat med school like an 8-6 job and go to class: I did this with great results for the second half of my second year. This academic year, I've had very strange mandatory hours so it's less possible. But I'm still trying to get a good amount of studying done while at work in between tasks rather than late at night.
read more real news and less celebrity gossip news: I'm doing okay on this. Recently I've been spending less time on the internet in general, and when I am on it's more likely to be reading blogs than celeb gossip. Equally empty, but more down to earth? I also make an effort to try and read drudge report but I'm pretty sure that his representation of the news is also biased
become a ridiculously awesome triathlete: ha ha ha! I did one more painful triathlon because my mom made me and have since realized that it's her dream, not really mine.
stop wearing athletic clothes to look like I am about to go work out but really I was too lazy to put together a normal outfit: I'm wearing scrubs right now. Does that count as real clothes?
stop allowing starbucks to suck away half of my food budget: success. This went along with changing my study hours (no late night coffee and "study" sessions anymore=me cutting back significantly on starbucks expenditures!)
read the entire Bible in a year: ambitious goal, not accomplished. I think I made it through March then got hopelessly behind.

This year's resolutions:
1) do cardio at minimum three times per week, and weights two to three times. This is to prevent me from turning into a pile of sludge.
2) limit eating out to two nights per week, and bring lunches from home during the day.
3) try to become more patient... or at least act more patient.
4) change out of scrubs at the end of the work day.
5) get more sleep, preferably not in nap form.
6) make more lists.

today was first day of OB/Gyn. I'm a little terrified of OB, and even more terrified of childbirth (experiencing it). did you know that more than 3/4 of current female OB/Gyn residents would elect to have a scheduled C-Section for their first pregnancy over a natural delivery? Also, apparently 1/250 new babies in the USA is born in Parkland Hospital, and 1/24 new Texans annually. That's INSANE.

Sunday, January 4, 2009


This one is called three truths and a lie... which image does not have to do with my impending nuptials?

Saturday, January 3, 2009

By the way...

For anyone who reads this thing and doesn't already know, E and I are engaged. We're getting married October 3. For those keeping track, we've been dating for a little over 2.5 months... but within the first week I was telling all my friends that I was planning to marry him! I think he asked me for the first time about a week and a half after we started dating. It wasn't the classical down on one knee after a fancy dinner thing, it was more like "I LOVE you! let's get married" and I said "That sounds awesome!". He's asked me daily since then and I continue to say yes (obviously). I was going to keep it on the DL until I had my official ring, but then I forgot and started telling people. He's designing the ring himself, without my input. I don't get to see it pre-him putting it on my finger. That's trust.
Other details... we're getting married at First United Methodist (of course... that was the first thing we booked!) and having the reception at a winery called Times Ten Cellars. We're asking one of E's friends who's a very talented chef if he's available for catering. My sister Shannon has offered to do our flowers. The wedding is going to be beautiful, the reception is going to be a labor of love, and the marriage is going to be the best part of it all.

now notice how delicious this thing looks. mmmmmmyech. It does look delicious if I'm feeling self-destructive. I'll revisit this image next week after I'm stressed out from delivering babies at parkland the baby factory. Also, my posts should become way more interesting when I'm in L&D. and possibly horrifying.